{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T10:21:21Z","timestamp":1780482081229,"version":"3.54.1"},"reference-count":68,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec id=\"st1\">\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To compare palatal symmetry, dimensions, and molar angulations following early mixed-dentition slow maxillary expansion with parameters in normal controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st2\">\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>\n                      A total of 30 patients treated with a Haas-type expander for unilateral posterior crossbite with functional shift were compared with 30 controls matched for dental age, gender, and molar relationship. Records were taken before (T1) and after expansion (T2). Palatal width, surface area, volume, and molar angulations were measured on digitized models. Surface area and volume were split in half then divided into anterior, middle, and posterior segments to measure symmetry. Student's\n                      <jats:italic>t<\/jats:italic>\n                      -test was used to assess group differences.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Mean intercanine width increased 4.65 mm, and intermolar width increased 4.76 mm. The treated mean surface area increased 127.05 mm\n                      <jats:sup>2<\/jats:sup>\n                      compared with 10.35 mm\n                      <jats:sup>2<\/jats:sup>\n                      in controls. The treated palatal volume increased 927.55 mm\n                      <jats:sup>3<\/jats:sup>\n                      compared with 159.89 mm\n                      <jats:sup>3<\/jats:sup>\n                      for controls. At T1, the controls showed significant differences in surface area and volume between the anterior palatal segments. At T2, this difference occurred in surface area of middle palatal segments of the treated sample. First permanent molars showed an increased buccal and distal inclination after treatment, opposite to controls. The increase in buccal inclination was greater on the crossbite side.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st4\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The Haas-type expander results in similar expansion across the canines and first molars. A palate that is symmetrical before expansion may become asymmetric after expansion but only in the middle segment. Changes in individual molar angulation following palatal expansion can be measured without radiation imaging.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2319\/082317-571.1","type":"journal-article","created":{"date-parts":[[2018,3,21]],"date-time":"2018-03-21T12:42:26Z","timestamp":1521636146000},"page":"390-396","source":"Crossref","is-referenced-by-count":18,"title":["Dimensional changes in the palate associated with slow maxillary expansion for early treatment of posterior crossbite"],"prefix":"10.2319","volume":"88","author":[{"given":"Abdulkadir","family":"Bukhari","sequence":"first","affiliation":[{"name":"Graduate Student, Department of Oral Health Sciences, The University of British Columbia, Vancouver, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Clinical Professor, Co-clinic Director, Graduate Orthodontics, Department of Oral Health Sciences, The University of British Columbia, Vancouver, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Hannam","sequence":"additional","affiliation":[{"name":"Professor Emeritus, Department of Oral Health Sciences, The University of British Columbia, Vancouver, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jolanta","family":"Aleksej\u016bnien\u0117","sequence":"additional","affiliation":[{"name":"Associate Professor and Chair, Preventive and Community Dentistry Department, The University of British Columbia, Vancouver, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edwin","family":"Yen","sequence":"additional","affiliation":[{"name":"Professor, Department of Oral Health Sciences, The University of British Columbia, Vancouver, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"key":"i0003-3219-88-4-390-b01","series-title":"Am J Orthod","first-page":"491","article-title":"Posterior cross-bites in the deciduous and mixed dentitions","volume":"56","author":"Kutin \n              G.","year":"1969","unstructured":"Kutin \n              G.\n            \n            \n              Hawes \n              RR.\n            \n          \n          Posterior cross-bites in the deciduous and mixed dentitions. Am J Orthod. 1969;56:491\u2013504."},{"key":"i0003-3219-88-4-390-b02","series-title":"Scand J Dent Res","first-page":"12","article-title":"The prevalence of malocclusion in Swedish schoolchildren","volume":"81","author":"Thilander \n              B.","year":"1973","unstructured":"Thilander \n              B.\n            \n            \n              Myrberg \n              N.\n            \n          \n          The prevalence of malocclusion in Swedish schoolchildren. Scand J Dent Res. 1973;81:12\u201320."},{"key":"i0003-3219-88-4-390-b03","series-title":"Eur J Orthod","first-page":"173","article-title":"Longitudinal study and cost-benefit analysis of the effect of early treatment of posterior cross-bites in the primary dentition","volume":"14","author":"Kurol \n              J.","year":"1992","unstructured":"Kurol \n              J.\n            \n            \n              Berglund \n              L.\n            \n          \n          Longitudinal study and cost-benefit analysis of the effect of early treatment of posterior cross-bites in the primary dentition. Eur J Orthod. 1992;14:173\u2013179."},{"key":"i0003-3219-88-4-390-b04","series-title":"ASDC J Dent Child","first-page":"385","article-title":"Thumb-sucking: literature review","volume":"60","author":"Johnson \n              ED.","year":"1993","unstructured":"Johnson \n              ED.\n            \n            \n              Larson \n              BE.\n            \n          \n          Thumb-sucking: literature review. ASDC J Dent Child. 1993;60:385\u2013391."},{"key":"i0003-3219-88-4-390-b05","series-title":"Eur J Orthod","first-page":"25","article-title":"The effect of early interceptive treatment in children with posterior cross-bite","volume":"6","author":"Thilander \n              B.","year":"1984","unstructured":"Thilander \n              B.\n            \n            \n              Wahlund \n              S.\n            \n            \n              Lennartsson \n              B.\n            \n          \n          The effect of early interceptive treatment in children with posterior cross-bite. Eur J Orthod. 1984;6:25\u201334."},{"key":"i0003-3219-88-4-390-b06","series-title":"Eur J Oral Sci","first-page":"278","article-title":"Relation between sucking habits and dental characteristics in preschoolchildren with unilateral cross-bite","volume":"97","author":"Lindner \n              A.","year":"1989","unstructured":"Lindner \n              A.\n            \n            \n              Mod\u00e9er \n              T.\n            \n          \n          Relation between sucking habits and dental characteristics in preschoolchildren with unilateral cross-bite. Eur J Oral Sci. 1989;97:278\u2013283."},{"key":"i0003-3219-88-4-390-b07","series-title":"Contemporary Orthodontics. 4th ed","author":"Proffit \n              WR.","year":"2007","unstructured":"Proffit \n              WR.\n            \n            \n              Fields \n              HW.\n            \n            \n              Sarver \n              DM.\n            \n          \n          Contemporary Orthodontics. 4th ed. St. Louis, MO: Mosby Elsevier;2007:437."},{"key":"i0003-3219-88-4-390-b08","series-title":"Am J Orthod Dentofacial Orthop","first-page":"410","article-title":"Changes in condylar position and occlusion associated with maxillary expansion for correction of functional unilateral posterior crossbite","volume":"111","author":"Hesse \n              KL.","year":"1997","unstructured":"Hesse \n              KL.\n            \n            \n              \u00c5rtun \n              J.\n            \n            \n              Joondeph \n              DR.\n            \n            \n              Kennedy \n              DB.\n            \n          \n          Changes in condylar position and occlusion associated with maxillary expansion for correction of functional unilateral posterior crossbite. Am J Orthod Dentofacial Orthop. 1997;111:410\u2013418."},{"key":"i0003-3219-88-4-390-b09","series-title":"Pediatr Dent","first-page":"266","article-title":"Correction of posterior crossbites: diagnosis and treatment","volume":"26","author":"Binder \n              RE.","year":"2004","unstructured":"Binder \n              RE.\n            \n          \n          Correction of posterior crossbites: diagnosis and treatment. Pediatr Dent. 2004;26:266\u2013272."},{"key":"i0003-3219-88-4-390-b10","series-title":"Eur J Orthod","first-page":"155","article-title":"The functional shift of the mandible in unilateral posterior crossbite and the adaptation of the temporomandibular joints: a pilot study","volume":"21","author":"Nerder \n              PH.","year":"1999","unstructured":"Nerder \n              PH.\n            \n            \n              Bakke \n              M.\n            \n            \n              Solow \n              B.\n            \n          \n          The functional shift of the mandible in unilateral posterior crossbite and the adaptation of the temporomandibular joints: a pilot study. Eur J Orthod. 1999;21:155\u2013166."},{"key":"i0003-3219-88-4-390-b11","series-title":"Am J Orthod Dentofacial Orthop","first-page":"394","article-title":"An evaluation of mandibular asymmetry in adults with unilateral posterior crossbite","volume":"107","author":"O'Byrn \n              BL.","year":"1995","unstructured":"O'Byrn \n              BL.\n            \n            \n              Sadowsky \n              C.\n            \n            \n              Schneider \n              B.\n            \n            \n              BeGole \n              EA.\n            \n          \n          An evaluation of mandibular asymmetry in adults with unilateral posterior crossbite. Am J Orthod Dentofacial Orthop. 1995;107:394\u2013400."},{"key":"i0003-3219-88-4-390-b12","series-title":"Am J Orthod","first-page":"32","article-title":"A review of maxillary expansion in relation to rate of expansion and patient's age","volume":"81","author":"Bell \n              RA.","year":"1982","unstructured":"Bell \n              RA.\n            \n          \n          A review of maxillary expansion in relation to rate of expansion and patient's age. Am J Orthod. 1982;81:32\u201337."},{"key":"i0003-3219-88-4-390-b13","series-title":"Am J Orthod Dentofacial Orthop","first-page":"331","article-title":"Treatment response and stability of slow maxillary expansion using Haas, hyrax, and quad-helix appliances: a retrospective study","volume":"136","author":"Huynh \n              T.","year":"2009","unstructured":"Huynh \n              T.\n            \n            \n              Kennedy \n              DB.\n            \n            \n              Joondeph \n              DR.\n            \n            \n              Bollen \n              A.\n            \n          \n          Treatment response and stability of slow maxillary expansion using Haas, hyrax, and quad-helix appliances: a retrospective study. Am J Orthod Dentofacial Orthop. 2009;136:331\u2013339."},{"key":"i0003-3219-88-4-390-b14","series-title":"Eur J Orthod","first-page":"26","article-title":"A photogrammetric technique for the analysis of palatal three-dimensional changes during rapid maxillary expansion","volume":"29","author":"Marini \n              I.","year":"2007","unstructured":"Marini \n              I.\n            \n            \n              Bonetti \n              GA.\n            \n            \n              Achilli \n              V.\n            \n            \n              Salemi \n              G.\n            \n          \n          A photogrammetric technique for the analysis of palatal three-dimensional changes during rapid maxillary expansion. Eur J Orthod. 2007;29:26\u201330."},{"key":"i0003-3219-88-4-390-b15","series-title":"Orthod Craniofac Res","first-page":"30","article-title":"Remodelling of the palatal dome following rapid maxillary expansion (RME): laser scan-quantifications during a low growth period","volume":"15","author":"Muchitsch \n              AP.","year":"2012","unstructured":"Muchitsch \n              AP.\n            \n            \n              Winsauer \n              H.\n            \n            \n              Wendl \n              B.\n            \n            et al. \n          Remodelling of the palatal dome following rapid maxillary expansion (RME): laser scan-quantifications during a low growth period. Orthod Craniofac Res. 2012;15:30\u201338."},{"key":"i0003-3219-88-4-390-b16","series-title":"Am J Orthod Dentofacial Orthop","first-page":"354","article-title":"Three-dimensional assessment of morphologic changes of the maxilla: A comparison of 2 kinds of palatal expanders","volume":"126","author":"Oliveira \n              NL.","year":"2004","unstructured":"Oliveira \n              NL.\n            \n            \n              Da Silveira \n              AC.\n            \n            \n              Kusnoto \n              B.\n            \n            \n              Viana \n              G.\n            \n          \n          Three-dimensional assessment of morphologic changes of the maxilla: A comparison of 2 kinds of palatal expanders. Am J Orthod Dentofacial Orthop. 2004;126:354\u2013362."},{"key":"i0003-3219-88-4-390-b17","series-title":"Am J Orthod Dentofacial Orthop","first-page":"370","article-title":"Relationship between rapid maxillary expansion and nasal cavity size and airway resistance: short- and long-term effects","volume":"134","author":"De Felippe \n              O.","year":"2008","unstructured":"De Felippe \n              O.\n            \n            \n              Nanci \n              L.\n            \n            \n              Da Silveira \n              AC.\n            \n            et al. \n          Relationship between rapid maxillary expansion and nasal cavity size and airway resistance: short- and long-term effects. Am J Orthod Dentofacial Orthop. 2008;134:370\u2013382."},{"key":"i0003-3219-88-4-390-b18","series-title":"Am J Orthod Dentofacial Orthop","first-page":"477","article-title":"Three-dimensional computed tomography comparison of the maxillary palatal vault between patients with rapid palatal expansion and orthodontically treated controls","volume":"138","author":"Gohl \n              E.","year":"2010","unstructured":"Gohl \n              E.\n            \n            \n              Nguyen \n              M.\n            \n            \n              Enciso \n              R.\n            \n          \n          Three-dimensional computed tomography comparison of the maxillary palatal vault between patients with rapid palatal expansion and orthodontically treated controls. Am J Orthod Dentofacial Orthop. 2010;138:477\u2013485."},{"key":"i0003-3219-88-4-390-b19","series-title":"Eur J Orthod","first-page":"352","article-title":"Early crossbite correction: a three-dimensional evaluation","volume":"31","author":"Primo\u017ei\u010d \n              J.","year":"2009","unstructured":"Primo\u017ei\u010d \n              J.\n            \n            \n              Ovsenik \n              M.\n            \n            \n              Richmond \n              S.\n            \n            \n              Kau \n              CH.\n            \n            \n              Zhurov \n              A.\n            \n          \n          Early crossbite correction: a three-dimensional evaluation. Eur J Orthod. 2009;31:352\u2013356."},{"key":"i0003-3219-88-4-390-b20","series-title":"Eur J Orthod","first-page":"199","article-title":"Three-dimensional assessment of palatal change in a controlled study of unilateral posterior crossbite correction in the primary dentition","volume":"35","author":"Primo\u017eic \n              J.","year":"2013","unstructured":"Primo\u017eic \n              J.\n            \n            \n              Baccetti \n              T.\n            \n            \n              Franchi \n              L.\n            \n            \n              Richmond \n              S.\n            \n            \n              Far\u010dnik \n              F.\n            \n            \n              Ovsenik \n              M.\n            \n          \n          Three-dimensional assessment of palatal change in a controlled study of unilateral posterior crossbite correction in the primary dentition. Eur J Orthod. 2013;35:199\u2013204."},{"key":"i0003-3219-88-4-390-b21","series-title":"Eur J Orthod","first-page":"7","article-title":"Three-dimensional evaluation of early crossbite correction: a longitudinal study","volume":"35","author":"Primo\u017ei\u010d \n              J.","year":"2013","unstructured":"Primo\u017ei\u010d \n              J.\n            \n            \n              Richmond \n              S.\n            \n            \n              Kau \n              CH.\n            \n            \n              Zhurov \n              A.\n            \n            \n              Ovsenik \n              M.\n            \n          \n          Three-dimensional evaluation of early crossbite correction: a longitudinal study. Eur J Orthod. 2013;35:7\u201313."},{"key":"i0003-3219-88-4-390-b22","series-title":"Angle Orthod","first-page":"129","article-title":"Nonsurgical rapid maxillary expansion in adults: report on 47 cases using the Haas expander","volume":"70","author":"Handelman \n              CS.","year":"2000","unstructured":"Handelman \n              CS.\n            \n            \n              Wang \n              L.\n            \n            \n              BeGole \n              EA.\n            \n            \n              Haas \n              AJ.\n            \n          \n          Nonsurgical rapid maxillary expansion in adults: report on 47 cases using the Haas expander. 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Am J Orthod Dentofacial Orthop. 2008;133:790.e7\u2013790.e13."},{"key":"i0003-3219-88-4-390-b27","series-title":"Am J Orthod Dentofacial Orthop","first-page":"321","article-title":"Comparison of skeletal and dental changes between 2-point and 4-point rapid palatal expanders","volume":"123","author":"Lamparski \n              DG.","year":"2003","unstructured":"Lamparski \n              DG.\n            \n            \n              Rinchuse \n              DJ.\n            \n            \n              Close \n              JM.\n            \n            \n              Sciote \n              JJ.\n            \n          \n          Comparison of skeletal and dental changes between 2-point and 4-point rapid palatal expanders. Am J Orthod Dentofacial Orthop. 2003;123:321\u2013328."},{"key":"i0003-3219-88-4-390-b28","series-title":"Am J Orthod Dentofacial Orthop","first-page":"194","article-title":"Arch perimeter changes on rapid palatal expansion","volume":"97","author":"Adkins \n              MD.","year":"1990","unstructured":"Adkins \n              MD.\n            \n            \n              Nanda \n              RS.\n            \n            \n              Currier \n              GF.\n            \n          \n          Arch perimeter changes on rapid palatal expansion. Am J Orthod Dentofacial Orthop. 1990;97:194\u2013199."},{"key":"i0003-3219-88-4-390-b29","series-title":"Semin Orthod","first-page":"176","article-title":"Maxillary adaptation to expansion in the mixed dentition","volume":"1","author":"Spillane \n              LM.","year":"1995","unstructured":"Spillane \n              LM.\n            \n            \n              McNamara Jr \n              JA.\n            \n          \n          Maxillary adaptation to expansion in the mixed dentition. 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Pediatric Dental Journal. 2010;20:78\u201383."},{"key":"i0003-3219-88-4-390-b31","article-title":"What Parents Should Know about the Safety of Dental Radiology","unstructured":"What Parents Should Know about the Safety of Dental Radiology. Available at: http:\/\/www.imagegently.org\/LinkClick.aspx?fileticket=2EUpQxTchIc%3d&portalid=6. Last accessed date: Copyright 2014."},{"key":"i0003-3219-88-4-390-b32","series-title":"Eur J Orthod","first-page":"67","article-title":"A comparison of dentoalveolar inclination treated by two palatal expanders","volume":"30","author":"K\u0131l\u0131\u00e7 \n              N.","year":"2008","unstructured":"K\u0131l\u0131\u00e7 \n              N.\n            \n            \n              Kiki \n              A.\n            \n            \n              Oktay \n              H.\n            \n          \n          A comparison of dentoalveolar inclination treated by two palatal expanders. Eur J Orthod. 2008;30:67\u201372."},{"key":"i0003-3219-88-4-390-b33","series-title":"Is it better in the mixed or in the permanent dentition? Angle Orthod","first-page":"654","article-title":"Rapid maxillary expansion","volume":"73","author":"Sari \n              Z.","year":"2003","unstructured":"Sari \n              Z.\n            \n            \n              Uysal \n              T.\n            \n            \n              Usumez \n              S.\n            \n            \n              Basciftci \n              FA.\n            \n          \n          Rapid maxillary expansion. Is it better in the mixed or in the permanent dentition? Angle Orthod. 2003;73:654\u2013661."},{"key":"i0003-3219-88-4-390-b34","series-title":"Am J Orthod Dentofacial Orthop","first-page":"615","article-title":"Transverse molar movements during growth","volume":"124","author":"Marshall \n              S.","year":"2003","unstructured":"Marshall \n              S.\n            \n            \n              Dawson \n              D.\n            \n            \n              Southard \n              KA.\n            \n            \n              Lee \n              AN.\n            \n            \n              Casko \n              JS.\n            \n            \n              Southard \n              TE.\n            \n          \n          Transverse molar movements during growth. Am J Orthod Dentofacial Orthop. 2003;124:615\u2013624."},{"key":"i0003-3219-88-4-390-b01","series-title":"Am J Orthod","first-page":"491","article-title":"Posterior cross-bites in the deciduous and mixed dentitions","volume":"56","author":"Kutin \n              G.","year":"1969","unstructured":"Kutin \n              G.\n            \n            \n              Hawes \n              RR.\n            \n          \n          Posterior cross-bites in the deciduous and mixed dentitions. Am J Orthod. 1969;56:491\u2013504."},{"key":"i0003-3219-88-4-390-b02","series-title":"Scand J Dent Res","first-page":"12","article-title":"The prevalence of malocclusion in Swedish schoolchildren","volume":"81","author":"Thilander \n              B.","year":"1973","unstructured":"Thilander \n              B.\n            \n            \n              Myrberg \n              N.\n            \n          \n          The prevalence of malocclusion in Swedish schoolchildren. Scand J Dent Res. 1973;81:12\u201320."},{"key":"i0003-3219-88-4-390-b03","series-title":"Eur J Orthod","first-page":"173","article-title":"Longitudinal study and cost-benefit analysis of the effect of early treatment of posterior cross-bites in the primary dentition","volume":"14","author":"Kurol \n              J.","year":"1992","unstructured":"Kurol \n              J.\n            \n            \n              Berglund \n              L.\n            \n          \n          Longitudinal study and cost-benefit analysis of the effect of early treatment of posterior cross-bites in the primary dentition. Eur J Orthod. 1992;14:173\u2013179."},{"key":"i0003-3219-88-4-390-b04","series-title":"ASDC J Dent Child","first-page":"385","article-title":"Thumb-sucking: literature review","volume":"60","author":"Johnson \n              ED.","year":"1993","unstructured":"Johnson \n              ED.\n            \n            \n              Larson \n              BE.\n            \n          \n          Thumb-sucking: literature review. ASDC J Dent Child. 1993;60:385\u2013391."},{"key":"i0003-3219-88-4-390-b05","series-title":"Eur J Orthod","first-page":"25","article-title":"The effect of early interceptive treatment in children with posterior cross-bite","volume":"6","author":"Thilander \n              B.","year":"1984","unstructured":"Thilander \n              B.\n            \n            \n              Wahlund \n              S.\n            \n            \n              Lennartsson \n              B.\n            \n          \n          The effect of early interceptive treatment in children with posterior cross-bite. Eur J Orthod. 1984;6:25\u201334."},{"key":"i0003-3219-88-4-390-b06","series-title":"Eur J Oral Sci","first-page":"278","article-title":"Relation between sucking habits and dental characteristics in preschoolchildren with unilateral cross-bite","volume":"97","author":"Lindner \n              A.","year":"1989","unstructured":"Lindner \n              A.\n            \n            \n              Mod\u00e9er \n              T.\n            \n          \n          Relation between sucking habits and dental characteristics in preschoolchildren with unilateral cross-bite. Eur J Oral Sci. 1989;97:278\u2013283."},{"key":"i0003-3219-88-4-390-b07","series-title":"Contemporary Orthodontics. 4th ed","author":"Proffit \n              WR.","year":"2007","unstructured":"Proffit \n              WR.\n            \n            \n              Fields \n              HW.\n            \n            \n              Sarver \n              DM.\n            \n          \n          Contemporary Orthodontics. 4th ed. St. Louis, MO: Mosby Elsevier;2007:437."},{"key":"i0003-3219-88-4-390-b08","series-title":"Am J Orthod Dentofacial Orthop","first-page":"410","article-title":"Changes in condylar position and occlusion associated with maxillary expansion for correction of functional unilateral posterior crossbite","volume":"111","author":"Hesse \n              KL.","year":"1997","unstructured":"Hesse \n              KL.\n            \n            \n              \u00c5rtun \n              J.\n            \n            \n              Joondeph \n              DR.\n            \n            \n              Kennedy \n              DB.\n            \n          \n          Changes in condylar position and occlusion associated with maxillary expansion for correction of functional unilateral posterior crossbite. 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